Hernie diaphragmatique post-traumatique de l’enfant: à propos d’un cas au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou

La hernie diaphragmatique post-traumatique est une urgence chirurgicale rare chez l’enfant mais pouvant mettre rapidement en jeu le pronosticvital. Les auteurs rapportent le cas d’un garçon de 04 ans admis aux urgences pour douleur abdominale suite à une contusion thoraco-abdominale par accident de la voie publique. Le bilan radiologique initial a consisté en une échographie abdominale qui a révélé un hémopéritoine de petite abondance sans lésion focale. Douze heures après son admission, le patient a présenté une détresse respiratoire avec tableau clinique depneumothorax gauche qui a nécessité une exsufflation en urgence. Le diagnostic de hernie diaphragmatique gauche a été posé à la radiographiedu thorax réalisée après la ponction. L’enfant a bénéficié d’une cure  chirurgicale. L’évolution a été favorable. La hernie diaphragmatique posttraumatique, bien que rare chez l’enfant, devrait être systématiquement recherchée par une radiographie thoracique ou un scanner  thoracoabdominal devant tout traumatisme abdominal avec hyper pression. Son traitement est chirurgical

Vasodilator effect of Zanthoxylum zanthoxyloïdes, Calotropis procera and FACA, a mixture of these two plants

Root bark extracts from Zanthoxylum zanthoxyloides Lam (Rutaceae) and Calotropis procera Aït (Asclepiadaceae) were used in Burkina Faso folk medicine for several diseases particularly sickle cell anemia. Authors reported here vasorelaxant effect of these plants on rat isolated aorta. Z. zanthoxyloïdes (cumulative addition) produces a concentration-dependent relaxation on the aorta. Maximal effects are respectively of 60.34 ± 2.34 and 100% in the presence and in the absence of endothelium. C. procera extract induces a more relaxing effect on endothelium-denuded aorta (Emax = 59.78 ± 2.13% and 100% in presence and absence of endothelium respectively). FACA, the mixture of these two plants also induces vasorelaxation (Emax = 100%), with better effect in the presence of endothelium (EC50 = 2.76 ± 0.38 mg/mL and 4.90 ± 0.69 mg/mL in presence and absence of endothelium respectively). Endothelium-dependent vasodilator effect of FACA was inhibited by L-NAME; this clearly indicates that NO is involved in aorta relaxation process by FACA. Taken together this study revealed that FACA and its components possess vasodilator effect. This vascular property of FACA may be involved in the amendment of sickle cell crisis through inhibition of vaso-occlusion process.Keywords: Sickle cell anemia, phytotherapy, rat aorta, endotheliu

Outpatient prescriptions practice and writing quality in a paediatric university hospital.

BACKGROUND: The writing of prescriptions is an important aspect of medical practice. This activity presents some specific problems given a danger of misinterpretation and dispensing errors in community pharmacies. The objective of this study was to determine the evolution of the prescription practice and writing quality in the outpatient clinics of our paediatric university hospital.¦METHODS: Copies of prescriptions written by physicians were collected from community pharmacies in the region of our hospital for a two-month period in 2005 and 2010. They were analysed according to standard criteria, including both formal and pharmaceutical aspects.¦RESULTS: A total of 597 handwritten prescriptions were reviewed in 2005 and 633 in 2010. They contained 1,456 drug prescriptions in 2005 and 1,348 in 2010. Fifteen drugs accounted for 80% of all prescriptions and the most common drugs were paracetamol and ibuprofen. A higher proportion of drugs were prescribed as International Nonproprietary Names (INN) or generics in 2010 (24.7%) compared with 2005 (20.9%). Of the drug prescriptions examined, 55.5% were incomplete in 2005 and 69.2% in 2010. Moreover in 2005, 3.2% were legible only with difficulty, 22.9% were ambiguous, and 3.0% contained an error. These proportions rose respectively to 5.2%, 27.8%, and 6.8% in 2010.¦CONCLUSION: This study showed that fifteen different drugs represented the majority of prescriptions, and a quarter of them were prescribed as INN or generics in 2010; and that handwritten prescriptions contained numerous omissions and preventable errors. In our hospital computerised prescribing coupled with advanced decision support is eagerly awaited

Evaluation of rice cultivars for resistance to rice yellow mottle virus

Rice yellow mottle virus (RYMV), which is only found in Africa, threatens rice farming on the continent. A local Oryza sativa cultivar collected from Burkina Faso (named BM24), was evaluated with that of well known highly resistant and tolerant cultivars. Firstly, three RYMV isolates were used to characterise the differential interaction within the cultivars. Secondly, disease kinetics of symptom expression and virus titer on leaves at 21 days after inoculation were assessed using the BF1 isolate. Thirdly, the allelic profile of O. sativa varieties using SSR marker RM101 located on chromosome 12 was also assessed. IR64 showed susceptibility to all isolates; while Tog5681 was resistant to all isolates. Ng122 overcame the resistance of Gigante, with mild leaf symptoms at 42\ua0dpi. Azucena and BM24 had, therefore, different resistance level regarding the three isolates (Ng117b, Ng122 and Ng144). When infected with the isolate, BF1, BM24 and Azucena exhibited same resistance patterns in early growth stages with delayed of symptoms appearance, but BM24 outperformed Azucena at later stages. The virus content in the two accessions, at 14 days post inoculation, was statistically different with BM24, showing less virus compared to Azucena. However, the two accessions depicted an identical allelic profile at RM101 locus.Le virus de la panachure jaune du riz (RYMV) est end\ue9mique seulement en Afrique, et fait des ravages dans les rizi\ue8res du continent. Une vari\ue9t\ue9 de riz local (appel\ue9e BM24), r\ue9sistante au RYMV et collect\ue9e au Burkina Faso a \ue9t\ue9 compar\ue9e avec des cultivars bien connus qui sont r\ue9sistants ou tol\ue9rants au RYMV. Tout d\u2019abord, trois isolats ont \ue9t\ue9 utilis\ue9s pour caract\ue9riser les interactions diff\ue9rentielles au sein des cultivars. Ensuite, la cin\ue9tique de l\u2019expression des sympt\uf4mes de la maladie et le titre en virus sur les feuilles \ue0 21 jours apr\ue8s inoculation ont \ue9t\ue9 \ue9valu\ue9e avec l\u2019isolat BF1. Enfin, le profile all\ue9lique des vari\ue9t\ue9s de Oryza sativa a \ue9t\ue9 \ue9valu\ue9 au marqueur SSR RM101 situ\ue9 sur le chromosome 12. La vari\ue9t\ue9 IR64 s\u2019est av\ue9r\ue9e sensible \ue0 tous les isolats tandis que Tog5681 s\u2019est montr\ue9 r\ue9sistant \ue0 tous les isolats. L\u2019isolat Ng122 a surmont\ue9 la r\ue9sistance de Gigante avec la pr\ue9sence de sympt\uf4mes mod\ue9r\ue9s \ue0 42 jours apr\ue8s inoculation (JAI). Azucena et BM24 par contre ont eu diff\ue9rents niveaux de r\ue9sistance en pr\ue9sence des trois isolats (Ng117b, Ng122 and Ng144). Lorsqu\u2019ils sont infect\ue9s avec l\u2019isolat BF1, BM24 et Azucena expriment le m\ueame niveau de r\ue9sistance avec un retard de l\u2019apparition des sympt\uf4mes dans les premiers moments suivant l\u2019inoculation mais au-del\ue0 de 14 JAI, les sympt\uf4mes apparaissent plus rapidement chez Azucena compar\ue9 \ue0 BM24. A 14 JAI, le titre de virus contenu dans e cultivar Azucena est bien sup\ue9rieur statistiquement \ue0 celui de BM24. Cependant, les deux cultivars ont eu un profile all\ue9lique identique au locus RM101

Assessing the Climate-Smartness of the West Africa Agricultural Productivity Programme (WAAPP): What can we learn from Benin, Guinea, Niger, Togo and Chad projects?

Agriculture is the most important sector of the national economies in West Africa. However, the agricultural sector is faced with numerous challenges (declining soil fertility and land degradation, adverse climate change manifestations, demographic pressure, market instability and incidence of crop pests and diseases, etc.), compromising its ability to be a driving engine out of food insecurity and poverty. With the growing challenge of climate change and variability in West Africa, the agricultural production and food systems must undergo significant transformations to meet the interlinked challenges of achieving sustainability, increasing food security and responding to climate change. Climate-smart agriculture (CSA) is proposed as a solution to transform and reorient agricultural systems to support food security under the new realities of climate change

The walking estimated limitation stated by history (WELSH): a visual tool to self-reported walking impairment in a predominantly illiterate population

BACKGROUND: The prevalence of cardiovascular diseases is increasing in low-income countries. Various questionnaires to estimate walking capacity in patients are available in multiple languages but they are not suitable for illiterate patients. OBJECTIVE: The walking estimated limitation stated by history (WELSH) tool aims at rating individual walking disability using only drawings and four items. METHODS: A six-month prospective study was performed on new patients referred to the Department of Cardiology at the Centre Hospitalier Universitaire Sourô Sanou in Bobo-Dioulasso, Burkina Faso. We administered the WELSH tool after a short oral presentation in the patient\u27s language or dialect. Thereafter, patients performed a six-minute walking test in the hospital corridor under the supervision of a nurse who was blinded to the results of the WELSH score. We performed a step-by-step multilinear regression analysis to determine the factors predicting maximal walking distance (MWD). RESULTS: There were 40 female and 10 male patients in this study. Their ages ranged from 54.8 ± 10.7 years. Only 32% of the patients had attended primary school. Most patients were classified as stage I to III of the New York Heart Association (NYHA) classification. The objective measurement of MWD during a six-minute walking test showed no association with the subjects\u27 educational level, body mass index, NYHA stage or gender, but a significant correlation with the WELSH scores. The Spearman r-value for the WELSH score-to-MWD relationship was 0.605 (p < 0.001). CONCLUSIONS: The WELSH tool is feasible and correlated with measured MWD in a population of predominantly illiterate patients

Comparative evaluation of automated KingFisher Flex Purification System 96 (ThermoFisher Scientific) and manual QIAamp Viral RNA Mini Kit (Qiagen) extraction methods for SARS-CoV-2

Background: The extraction step of the viral material of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) influences the quality of reverse transcriptase-polymerase chain reaction (RT-PCR) results in diagnosis of coronavirus disease 2019 (COVID-19). The purpose of this cross-sectional study was to evaluate the diagnostic performance of the automated extraction system "KingFisher Flex Purification System 96 (ThermoFisher)" compared to the manual method with the "QIAamp Viral RNA Mini Kit (Qiagen)". Methodology: From October to December 2020, comparative diagnostic evaluation of two methods of SARSCoV-2 RNA extraction methods was conducted on 159 fresh and 120 frozen nasopharyngeal and oropharyngeal specimens collected from travellers and suspected cases or contacts of COVID-19 patients in Burkina Faso. The FastPlexTM Triplex 1-Step COVID 19 Detection Kit (RT-PCR, RNA extraction free) (Precigenome LLC) was used to amplify on the same PCR plate, RNA extracts from manual QIAamp Viral RNA Mini Kit and automated KingFisher Flex Purification System 96 (ThermoFisher) using the QuantStudio5 thermal cycler (Applied Biosystems). Analysis of the diagnostic performance of the SARS-CoV-2 RT-PCR assay following RNA extraction by the two methods was done using an online OpenEpi software. Results: For fresh samples, the study found a slightly higher RT-PCR positivity rate following manual extraction (12.6%) than automated extraction (9.4%). For frozen samples, the positivity rate was far higher for manual (38.33%) than automated extraction method (20.83%). The results show that the performance of the automated extraction was inferior when compared to the manual extraction for both fresh samples (sensitivity 35%, specificity 94.2%) and frozen samples (sensitivity 43.5%, specificity 93.2%). However, using McNemar Chi-square with Yates correction, there was no significant difference in positivity rate of RT-PCR (x2=0.76, p=0.38) between the two extraction methods for the fresh samples, but there was a significant difference (x2=12.9, p= 0.0003) in the extraction of the frozen samples. Conclusion: The results of this study showed that KingFisher Flex Purification System 96 (ThermoFisher) automatic extraction method was less sensitive and specific than QIAamp Viral RNA Mini Kit (Qiagen) manual extraction method. This information can serve as guide to laboratories in the choice of RNA extraction methods to use for RT-PCR detection of SARS-CoV-2

Task sharing for family planning services, Burkina Faso

© 2019, World Health Organization. All rights reserved. Problem In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services. Approach Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels. Local setting In Burkina Faso, only 15% (2563/17 087) of married women used modern contraceptives in 2010. Relevant changes Adoption of new policies and clinical care standards expanded task sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2574 implants to new users. No safety issues were reported. Lessons learnt The pilot project was feasible and safe, however, financial constraints are hindering scale-up efforts. Supportive supervision cascades were critical in ensuring success

Risk factors associated with HIV prevalence in pregnant women in Burkina Faso, from 2006 to 2014

Purpose of the study: To determine the socio-demographic factors influencing the dynamics of HIV prevalence among pregnant women in Burkina Faso.Material and methods: A total of 66,597 pregnant women from the 13 health regions of Burkina Faso were included in this study conducted between 2006 and 2014. Venous blood samples were collected and analyzed for the detection of HIV antibodies according to WHO / UNAIDS strategy II, using the mixed test Vironostika HIV Uniform II Plus O (Bio-Mérieux) and the test discriminating ImmunoCombII HIV-1 & 2 BiSpot (Orgenics). Samples with discordant results between the two tests, as well as those positive to HIV-2 or HIV-1 + 2, were retested with HIV BLOT 2.2 (MP Diagnostics). Sociodemographic data collected from the participants were correlated with their HIV status to determine key risk factors influencing HIV infection prevalence in Burkina Faso.Results: Sociodemographic data showed that the study population consisted mainly of married women (91.2%) at their first pregnancy (27.1%) with a large majority of them being housewives (86.2%) who did not attend any form of schooling (69.4%). About 88.4% had stayed longer than a year in the health region where they initially participated in the study and 55.8% were between 20 and 29 years of age. Overall HIV prevalence significantly dropped from 2.7 % in 2006 to 1.3% in 2014. However HIV seroprevalence in this study has varied significantly according to socio-demographic characteristics including marital status, parity, occupation, education, age group and the length of stay in the women's health community (p <0.0001). Factors sustaining HIV transmission included the status of being unmarried (OR=1.67 [1.42-1.97]), primigest (OR=1.64 [1.41-1.89]), having other occupations except being student (OR = 1.68 [1.20-2.33]), aged between 20-49 years (OR=3.14 [2.51-3.93]) and the duration of stay less than a year in their locality (OR=5.33 [4.61-10.16]) and these factors were identified as main risk factors associated with HIV prevalence.Conclusion: Burkina Faso remains among the countries with concentrated epidemics despite a significant reduction in the prevalence observed in this study. The inclusion of identified risk factors in the national HIV program could improve the quality of the response to the epidemic.Keywords: HIV-Pregnant Women-Risk Factors-Burkina Fas

Screening of BRCA1 (c.5177_5180delGAAA rs80357867 and c.4986+6T>C rs80358086) and the BRCA2 (c.6445_6446delAT rs80359592) genes for breast cancer prevention in Burkina Faso

BACKGROUND: The objective of this study is to search for mutations in the BRCA1 (c.5177_5180delGAAA and c.4986+6T>C) and BRCA2 genes (c.6445_6446delAT) in a population of women diagnosed with breast cancer.METHODS: This is a case-control study that involved 140 participants, including 70 patients with histologically diagnosed breast cancer and 70 healthy women without breast cancer. Mutations in the BRCA1 (rs80357867, rs80358086) and BRCA2 (rs80359592) genes were tested by real-time PCR. The 95% confidence interval Odds Ratio (OR) was used to estimate the associations between specific genotypes and breast cancer.RESULTS: The study revealed that no mutations were detected for rs80359592. Similarly, no reference allele (TTTC/TTTC) of rs80357867 was found in this study. However, the homozygous double mutant (-/) genotype of this rs80357867 was observed in 11.43% and 1.43% of patients and controls respectively, while 88.57% of patients and 98.57% of controls had a heterozygous deletion (TTTC/-). Concerning rs80358086, 8.57% of the patients had a heterozygous mutation (A/G) with no significantly risk association with occurrence of breast cancer (OR = 6.46; 95% CI: 0.75-55.21; p = 0.11). In addition, this heterozygous mutation was significantly associated with a family history of breast cancer (OR=128; 95% CI: 9.46-1730.93) and breast cancer risk in nonmultiparous women (OR=6; 95% CI: 1-35.90; p= 0.05) but no association with overweight/obesity (OR=1.66; 95% CI: 0.18-15.35; p=1).CONCLUSION: This study shows high frequencies of heterozygous mutation of rs80357867 and rs80358086 from patients. In Burkina Faso, these results could help with early diagnosis of breast cancer in patients